Mary E. Sweet, Luisa Mestroni, Matthew R.G. Taylor, Heart Failure Clinics, Volume 14, Issue 2, April 2018, Pages 215-224, ISSN 1551-7136, doi:10.1016/j.hfc.2017.12.003.
Friedreich ataxia: Cardiomyopathy is the presenting finding in only 5% of patients, cardiac dysfunction from congestive heart failure or arrhythmia accounts for an estimated 59% of death. Cardiac dysfunction includes left ventricular hypertrophy, systolic dysfunction, and diastolic dysfunction.
Monday, March 19, 2018
Sunday, March 18, 2018
Resting-state connectivity in neurodegenerative disorders: Is there potential for an imaging biomarker?
Christian Hohenfeld, Cornelius J. Werner, Kathrin Reetz, NeuroImage: Clinical, Available online 16 March 2018, ISSN 2213-1582, doi:10.1016/j.nicl.2018.03.013.
Biomarkers in whichever modality are tremendously important in diagnosing of disease, tracking disease progression and clinical trials. This applies in particular for disorders with a long disease course including pre-symptomatic stages, in which only subtle signs of clinical progression can be observed. Magnetic resonance imaging (MRI) biomarkers hold particular promise due to their relative ease of use, cost-effectiveness and non-invasivity. Studies measuring resting-state functional MR connectivity have become increasingly common during recent years and are well established in neuroscience and related fields. Its increasing application does of course also include clinical settings and therein neurodegenerative diseases. In the present review, we critically summarise the state of the literature on resting-state functional connectivity as measured with functional MRI in neurodegenerative disorders. In addition to an overview of the results, we briefly outline the methods applied to the concept of resting-state functional connectivity.
While there are many different neurodegenerative disorders cumulatively affecting a substantial number of patients, for most of the studies on resting-state fMRI is lacking. Plentiful amounts of papers are available for Alzheimer's disease (AD) and Parkinson's disease (PD), but only few works being available for the less common neurodegenerative diseases. This allows some conclusions on the potential of resting-state fMRI acting as a biomarker for the aforementioned two diseases, but only tentative statements for the others.
For rare neurodegenerative diseases, no clear conclusions can be drawn due to the few published results. Nevertheless, summarising available data points towards characteristic connectivity alterations in Huntington's disease, frontotemporal dementia, dementia with Lewy bodies, multiple systems atrophy Friedreich ataxia and the spinocerebellar ataxias.
Biomarkers in whichever modality are tremendously important in diagnosing of disease, tracking disease progression and clinical trials. This applies in particular for disorders with a long disease course including pre-symptomatic stages, in which only subtle signs of clinical progression can be observed. Magnetic resonance imaging (MRI) biomarkers hold particular promise due to their relative ease of use, cost-effectiveness and non-invasivity. Studies measuring resting-state functional MR connectivity have become increasingly common during recent years and are well established in neuroscience and related fields. Its increasing application does of course also include clinical settings and therein neurodegenerative diseases. In the present review, we critically summarise the state of the literature on resting-state functional connectivity as measured with functional MRI in neurodegenerative disorders. In addition to an overview of the results, we briefly outline the methods applied to the concept of resting-state functional connectivity.
While there are many different neurodegenerative disorders cumulatively affecting a substantial number of patients, for most of the studies on resting-state fMRI is lacking. Plentiful amounts of papers are available for Alzheimer's disease (AD) and Parkinson's disease (PD), but only few works being available for the less common neurodegenerative diseases. This allows some conclusions on the potential of resting-state fMRI acting as a biomarker for the aforementioned two diseases, but only tentative statements for the others.
For rare neurodegenerative diseases, no clear conclusions can be drawn due to the few published results. Nevertheless, summarising available data points towards characteristic connectivity alterations in Huntington's disease, frontotemporal dementia, dementia with Lewy bodies, multiple systems atrophy Friedreich ataxia and the spinocerebellar ataxias.
Optical coherence tomography in autosomal recessive spastic ataxia of Charlevoix-Saguenay
Michael H Parkinson, Ana P Bartmann, Lisa M S Clayton, Suran Nethisinghe, Rolph Pfundt, J Paul Chapple, Mary M Reilly, Hadi Manji, Nicholas J Wood, Fion Bremner, Paola Giunti; Brain, , awy028, doi:10.1093/brain/awy028
Autosomal recessive spastic ataxia of Charlevoix-Saguenay is a rare neurodegenerative disorder caused by mutations in the SACS gene. Thickened retinal nerve fibres visible on fundoscopy have previously been described in these patients; however, thickening of the retinal nerve fibre layer as demonstrated by optical coherence tomography appears to be a more sensitive and specific feature. To test this observation, we assessed 292 individuals (191 patients with ataxia and 101 control subjects) by peripapillary time-domain optical coherence tomography. The patients included 146 with a genetic diagnosis of ataxia (17 autosomal spastic ataxia of Charlevoix-Saguenay, 59 Friedreich’s ataxia, 53 spinocerebellar ataxias, 17 other genetically confirmed ataxias) and 45 with cerebellar ataxia of unknown cause. The controls included 13 asymptomatic heterozygotes for SACS mutations and 88 unaffected controls. The cases with autosomal recessive spastic ataxia of Charlevoix-Saguenay included 11 previously unpublished SACS mutations, of which seven were nonsense and four missense mutations. Most patients were visually asymptomatic and had no previous history of ophthalmic complaints and normal or near normal visual test results. None had visual symptoms directly attributable to the retinal changes. Twelve of the 17 cases (70.6%) had thickened retinal nerve fibres visible on fundoscopy. All patients with autosomal recessive spastic ataxia of Charlevoix-Saguenay had thickening of the peripapillary retinal nerve fibre layer on optical coherence tomography, whereas all the remaining cases and controls except one showed normal or reduced average peripapillary retinal nerve fibre layer thickness on optical coherence tomography. We propose a cut-off value of 119 µm in average peripapillary retinal nerve fibre layer thickness, which provides a sensitivity of 100% and specificity of 99.4% amongst patients affected with ataxia. This is the largest cohort of patients with this condition to undergo systematic evaluation by optical coherence tomography. This is a useful tool in identifying cases of autosomal recessive spastic ataxia of Charlevoix-Saguenay from other causes of ataxia. Visualization of thickened retinal fibres by direct fundoscopy is less sensitive. We therefore advocate the use of this technique in the assessment of possible cases of this condition.
Autosomal recessive spastic ataxia of Charlevoix-Saguenay is a rare neurodegenerative disorder caused by mutations in the SACS gene. Thickened retinal nerve fibres visible on fundoscopy have previously been described in these patients; however, thickening of the retinal nerve fibre layer as demonstrated by optical coherence tomography appears to be a more sensitive and specific feature. To test this observation, we assessed 292 individuals (191 patients with ataxia and 101 control subjects) by peripapillary time-domain optical coherence tomography. The patients included 146 with a genetic diagnosis of ataxia (17 autosomal spastic ataxia of Charlevoix-Saguenay, 59 Friedreich’s ataxia, 53 spinocerebellar ataxias, 17 other genetically confirmed ataxias) and 45 with cerebellar ataxia of unknown cause. The controls included 13 asymptomatic heterozygotes for SACS mutations and 88 unaffected controls. The cases with autosomal recessive spastic ataxia of Charlevoix-Saguenay included 11 previously unpublished SACS mutations, of which seven were nonsense and four missense mutations. Most patients were visually asymptomatic and had no previous history of ophthalmic complaints and normal or near normal visual test results. None had visual symptoms directly attributable to the retinal changes. Twelve of the 17 cases (70.6%) had thickened retinal nerve fibres visible on fundoscopy. All patients with autosomal recessive spastic ataxia of Charlevoix-Saguenay had thickening of the peripapillary retinal nerve fibre layer on optical coherence tomography, whereas all the remaining cases and controls except one showed normal or reduced average peripapillary retinal nerve fibre layer thickness on optical coherence tomography. We propose a cut-off value of 119 µm in average peripapillary retinal nerve fibre layer thickness, which provides a sensitivity of 100% and specificity of 99.4% amongst patients affected with ataxia. This is the largest cohort of patients with this condition to undergo systematic evaluation by optical coherence tomography. This is a useful tool in identifying cases of autosomal recessive spastic ataxia of Charlevoix-Saguenay from other causes of ataxia. Visualization of thickened retinal fibres by direct fundoscopy is less sensitive. We therefore advocate the use of this technique in the assessment of possible cases of this condition.
Saturday, March 17, 2018
Distinct effects of frataxin missence point mutations on mitochondrial localization, protein processing, and cellular metabolism
Clark, Elisia M., University of Pennsylvania, Philadelphia, PA, United States
National Institute of Health (NIH), National Institute of Neurological Disorders and Stroke (NINDS)
Type: Predoctoral Individual National Research Service Award.
Although the function of frataxin (FXN) remains unclear, it is a mitochondrial protein imperative for proper mitochondria function. Friedreich's ataxia patients who carry missense point mutations in FXN display phenotypic variability that is mutation selective for unclear reasons. These studies will examine the mechanism by which FRDA-associated missense mutations impair FXN processing and explore the influence they have on cellular metabolism, in addition to exploring the use of fatty acids as a potential therapeutic strategy.
National Institute of Health (NIH), National Institute of Neurological Disorders and Stroke (NINDS)
Type: Predoctoral Individual National Research Service Award.
Although the function of frataxin (FXN) remains unclear, it is a mitochondrial protein imperative for proper mitochondria function. Friedreich's ataxia patients who carry missense point mutations in FXN display phenotypic variability that is mutation selective for unclear reasons. These studies will examine the mechanism by which FRDA-associated missense mutations impair FXN processing and explore the influence they have on cellular metabolism, in addition to exploring the use of fatty acids as a potential therapeutic strategy.
Interactions of iron-bound frataxin with ISCU and ferredoxin on the cysteine desulfurase complex leading to Fe-S cluster assembly
ai Cai, Ronnie O. Frederick, Marco Tonelli, John L. Markley, Journal of Inorganic Biochemistry, Available online 15 March 2018, ISSN 0162-0134, doi:10.1016/j.jinorgbio.2018.03.007.
Frataxin (FXN) is involved in mitochondrial iron‑sulfur (Fe-S) cluster biogenesis and serves to accelerate Fe-S cluster formation. FXN deficiency is associated with Friedreich ataxia, a neurodegenerative disease. We have used a combination of isothermal titration calorimetry and multinuclear NMR spectroscopy to investigate interactions among the components of the biological machine that carries out the assembly of iron‑sulfur clusters in human mitochondria. Our results show that FXN tightly binds a single Fe2+ but not Fe3+. While FXN (with or without bound Fe2+) does not bind the scaffold protein ISCU directly, the two proteins interact mutually when each is bound to the cysteine desulfurase complex ([NFS1]2:[ISD11]2:[Acp]2), abbreviated as (NIA)2, where “N” represents the cysteine desulfurase (NFS1), “I” represents the accessory protein (ISD11), and “A” represents acyl carrier protein (Acp). FXN binds (NIA)2 weakly in the absence of ISCU but more strongly in its presence. Fe2+-FXN binds to the (NIA)2-ISCU2 complex without release of iron. However, upon the addition of both l-cysteine and a reductant (either reduced FDX2 or DTT), Fe2+ is released from FXN as consistent with Fe2+-FXN being the proximal source of iron for Fe-S cluster assembly.
Frataxin (FXN) is involved in mitochondrial iron‑sulfur (Fe-S) cluster biogenesis and serves to accelerate Fe-S cluster formation. FXN deficiency is associated with Friedreich ataxia, a neurodegenerative disease. We have used a combination of isothermal titration calorimetry and multinuclear NMR spectroscopy to investigate interactions among the components of the biological machine that carries out the assembly of iron‑sulfur clusters in human mitochondria. Our results show that FXN tightly binds a single Fe2+ but not Fe3+. While FXN (with or without bound Fe2+) does not bind the scaffold protein ISCU directly, the two proteins interact mutually when each is bound to the cysteine desulfurase complex ([NFS1]2:[ISD11]2:[Acp]2), abbreviated as (NIA)2, where “N” represents the cysteine desulfurase (NFS1), “I” represents the accessory protein (ISD11), and “A” represents acyl carrier protein (Acp). FXN binds (NIA)2 weakly in the absence of ISCU but more strongly in its presence. Fe2+-FXN binds to the (NIA)2-ISCU2 complex without release of iron. However, upon the addition of both l-cysteine and a reductant (either reduced FDX2 or DTT), Fe2+ is released from FXN as consistent with Fe2+-FXN being the proximal source of iron for Fe-S cluster assembly.
Thursday, March 15, 2018
Biomarcadores epigenéticos: hacia su implantación en la rutina clínica / Epigenetic biomarkers: towards their incorporation into clinical routine
José Luis García-Giménez, Gisselle Pérez-Machado, Jesús Beltrán-García, Eva García-López, Ester Berenguer-Pascual, Carlos Romá-Mateo, Federico Pallaró, Salvador Mena-Mollá; GENÉTICA MÉDICA · 14 de marzo de 2018 Núm.00 Vol.0 Genética Médica y Genómica revistageneticamedica.com
La práctica clínica requiere de nuevas técnicas que permitan la identificación de los individuos en riesgo de desarrollar una enfermedad mediante su detección eficaz y precoz, pero la clínica también necesita de herramientas que permitan predecir la evolución de la patología a lo largo del tiempo, así como su respuesta frente a un tratamiento. En la actualidad, los principales indicadores clínicos se basan en técnicas de imagen y ciertos biomarcadores que presentan limitaciones y que, en algunos casos, los biomarcadores epigenéticos han demostrado superar.
La comprensión de los mecanismos epigenéticos (metilación del ADN, modulación de las modificaciones postraduccionales de las histonas, y los ARN no codificantes) ha permitido que en las últimas décadas aparezcan multitud de nuevos candidatos para su uso como biomarcadores de diagnóstico y pronóstico de las enfermedades. Por eso, en esta revisión describimos los fundamentos de algunos biomarcadores epigenéticos y algunas técnicas y tecnologías que se están utilizando para su detección.
En un futuro cercano, este tipo de tecnologías se incorporarán a los laboratorios clínicos y, por lo tanto, el uso de estos biomarcadores se implementará en la rutina de diagnóstico clínico, contribuyendo así a la aplicación real de la teragnosis y mejorando la medicina de precisión.
EN
Epigenetic biomarkers: towards their incorporation into clinical routine
Clinical routine requires novel techniques in order to guarantee the identification of individuals in risk of developing a disease, in terms of an efficient and early detection; however, clinical management also needs tools that permit prediction of the long-term pathological evolution, as well as its response to any particular treatment. Currently, the main clinical indicators are based in imaging techniques and certain biomarkers, which show several limitations that, to some extent, biomarkers of an epigenetic nature have shown to overcome.
Comprehension of epigenetic mechanisms (i.e. DNA methylation, modulation of posttranslational histone modifications, and non-coding RNAs) has provided the apparition, in the last decades, of multiple new candidates for their use as diagnostic and prognostic biomarkers. Thus, in this review we describe some epigenetic biomarkers and several techniques and technologies which are being used for their detection.
In the near future, this type of technologies will be incorporated into clinical laboratories and, hence, the use of these biomarkers will be implemented into clinical diagnostic routine, contributing to the real application of theragnosis and improving precision medicine.
La práctica clínica requiere de nuevas técnicas que permitan la identificación de los individuos en riesgo de desarrollar una enfermedad mediante su detección eficaz y precoz, pero la clínica también necesita de herramientas que permitan predecir la evolución de la patología a lo largo del tiempo, así como su respuesta frente a un tratamiento. En la actualidad, los principales indicadores clínicos se basan en técnicas de imagen y ciertos biomarcadores que presentan limitaciones y que, en algunos casos, los biomarcadores epigenéticos han demostrado superar.
La comprensión de los mecanismos epigenéticos (metilación del ADN, modulación de las modificaciones postraduccionales de las histonas, y los ARN no codificantes) ha permitido que en las últimas décadas aparezcan multitud de nuevos candidatos para su uso como biomarcadores de diagnóstico y pronóstico de las enfermedades. Por eso, en esta revisión describimos los fundamentos de algunos biomarcadores epigenéticos y algunas técnicas y tecnologías que se están utilizando para su detección.
En un futuro cercano, este tipo de tecnologías se incorporarán a los laboratorios clínicos y, por lo tanto, el uso de estos biomarcadores se implementará en la rutina de diagnóstico clínico, contribuyendo así a la aplicación real de la teragnosis y mejorando la medicina de precisión.
EN
Epigenetic biomarkers: towards their incorporation into clinical routine
Clinical routine requires novel techniques in order to guarantee the identification of individuals in risk of developing a disease, in terms of an efficient and early detection; however, clinical management also needs tools that permit prediction of the long-term pathological evolution, as well as its response to any particular treatment. Currently, the main clinical indicators are based in imaging techniques and certain biomarkers, which show several limitations that, to some extent, biomarkers of an epigenetic nature have shown to overcome.
Comprehension of epigenetic mechanisms (i.e. DNA methylation, modulation of posttranslational histone modifications, and non-coding RNAs) has provided the apparition, in the last decades, of multiple new candidates for their use as diagnostic and prognostic biomarkers. Thus, in this review we describe some epigenetic biomarkers and several techniques and technologies which are being used for their detection.
In the near future, this type of technologies will be incorporated into clinical laboratories and, hence, the use of these biomarkers will be implemented into clinical diagnostic routine, contributing to the real application of theragnosis and improving precision medicine.
Wednesday, March 14, 2018
Large-scale computational drug repositioning to find treatments for rare diseases
Rajiv Gandhi Govindaraj, Misagh Naderi, Manali Singha, Jeffrey Lemoine & Michal Brylinski. npj Systems Biology and Applications 4, Article number: 13 (2018) doi:10.1038/s41540-018-0050-7
Computer-aided drug repositioning, i.e., finding new indications for existing drugs, is a cheaper and faster alternative to traditional drug discovery offering a promising venue for orphan drug research. Structure-based matching of drug-binding pockets is among the most promising computational techniques to inform drug repositioning. In order to find new targets for known drugs ultimately leading to drug repositioning, we recently developed eMatchSite, a new computer program to compare drug-binding sites. In this study, eMatchSite is combined with virtual screening to systematically explore opportunities to reposition known drugs to proteins associated with rare diseases.
Computer-aided drug repositioning, i.e., finding new indications for existing drugs, is a cheaper and faster alternative to traditional drug discovery offering a promising venue for orphan drug research. Structure-based matching of drug-binding pockets is among the most promising computational techniques to inform drug repositioning. In order to find new targets for known drugs ultimately leading to drug repositioning, we recently developed eMatchSite, a new computer program to compare drug-binding sites. In this study, eMatchSite is combined with virtual screening to systematically explore opportunities to reposition known drugs to proteins associated with rare diseases.
Genetic testing for clinically suspected spinocerebellar ataxias: report from a tertiary referral centre in India
Sowmya Devatha Venkatesh, Mahesh Kandasamy, Nagaraj S. Moily, Radhika Vaidyanathan, Lakshmi Narayanan Kota, Syama Adhikarla, Ravi Yadav, Pramod Kumar Pal, Sanjeev Jain, Meera Purushottam. J Genet (2018). doi:10.1007/s12041-018-0911-2
The prevalence of the syndromes of SCA varies across the world and is known to be linked to the instability of trinucleotide repeats within the high-end normal alleles, along with susceptible haplotype. We estimated sizes of the CAG or GAA repeat expansions at the SCA1, SCA2, SCA3, SCA12 and frataxin loci among 864 referrals of subjects to genetic counselling and testing (GCAT) clinic, National Institute of Mental Health and Neurosciences, Bengaluru, India, with suspected SCA. The most frequent mutations detected were SCA1 (n=100 (11.6%)) and SCA2 (n=98 (11.3%)) followed by SCA3 (n=40 (4.6%)), FRDA (n=20 (2.3%)) and SCA12 (n=8 (0.9%)).
The prevalence of the syndromes of SCA varies across the world and is known to be linked to the instability of trinucleotide repeats within the high-end normal alleles, along with susceptible haplotype. We estimated sizes of the CAG or GAA repeat expansions at the SCA1, SCA2, SCA3, SCA12 and frataxin loci among 864 referrals of subjects to genetic counselling and testing (GCAT) clinic, National Institute of Mental Health and Neurosciences, Bengaluru, India, with suspected SCA. The most frequent mutations detected were SCA1 (n=100 (11.6%)) and SCA2 (n=98 (11.3%)) followed by SCA3 (n=40 (4.6%)), FRDA (n=20 (2.3%)) and SCA12 (n=8 (0.9%)).
Tuesday, March 13, 2018
Bone marrow transplantation stimulates neural repair in Friedreich's ataxia mice
Kevin C Kemp, Kelly Hares, Juliana Redondo, Amelia J Cook, Harry R Haynes, Bronwen R Burton, Mark A Pook, Claire M Rice, Neil J Scolding and Alastair Wilkins; Annals of Neurology, Accepted manuscript online: 13 MAR 2018 DOI: 10.1002/ana.25207
Our data provide proof-of-concept of gene replacement therapy, via allogeneic bone marrow transplantation, that reverses neurological features of Friedreich's ataxia with the potential for rapid clinical translation.
Our data provide proof-of-concept of gene replacement therapy, via allogeneic bone marrow transplantation, that reverses neurological features of Friedreich's ataxia with the potential for rapid clinical translation.
Sunday, March 11, 2018
New Insights into the Role of Neuron-Specific Enolase in Neuro-Inflammation, Neurodegeneration, and Neuroprotection.
Haque A, Polcyn R, Matzelle D, Banik NL. Brain Sci. 2018 Feb;8(2) . doi:10.3390/brainsci8020033. PMID: 29463007; PMCID: PMC5836052.
Elevated NSE is thought to be a marker of oxidative damage and is the underlying parameter of several neurodegenerative disorders, including Huntington disease (HD), Friedreich ataxia, hereditary spastic paraplegia, rare familial forms Parkinson disease (PD), Alzheimer disease (AD), and amyotrophic lateral sclerosis (ALS).
Regulation of NSE via Cat X or other avenues may be important therapeutic strategies for prevention of inflammation and neurodegeneration in SCI and many other neurodegenerative diseases. Future studies should focus on the regulation of NSE for optimum attenuation of neuro-inflammation and promotion of neuroprotection in neurodegenerative conditions.
Elevated NSE is thought to be a marker of oxidative damage and is the underlying parameter of several neurodegenerative disorders, including Huntington disease (HD), Friedreich ataxia, hereditary spastic paraplegia, rare familial forms Parkinson disease (PD), Alzheimer disease (AD), and amyotrophic lateral sclerosis (ALS).
Regulation of NSE via Cat X or other avenues may be important therapeutic strategies for prevention of inflammation and neurodegeneration in SCI and many other neurodegenerative diseases. Future studies should focus on the regulation of NSE for optimum attenuation of neuro-inflammation and promotion of neuroprotection in neurodegenerative conditions.
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